Mental Health in relation to Quality of Life and Coping Strategies of adolescents

APPENDIX

Appendix I: Personal Data Sheet

NAME
(OPTIONAL)

Tick Wherever
Applicable

11yrs to 14 yrs
 1
Early Adolescence
15yrs to 18 yrs
AGE  2
Middle Adolescence
18yrs to 20 yrs
 3
Late Adolescence

 1 MALE
GENDER
 2 FEMALE

 1 ILLITERATE
 2 UNDERGRADUATE
 3 GRADUATE
FATHER’S
 4 POST GRADUATE
EDUCATION
 5 DOCTORATE
 6 ANY OTHER (SPECIFY)

 1 PRIVATE
 2 GOVERNMENT
FATHER’S  3 SELF EMPLOYED
OCCUPATION  4 UNEMPLOYED
 5 ANY OTHER, SPECIFY

 1 ILLITERATE
 2 UNDERGRADUATE
MOTHER’S  3 GRADUATE
EDUCATION  4 POST GRADUATE
 5 DOCTORATE
 6 ANY OTHER (SPECIFY)
Mental Health in relation to Quality of Life and Coping Strategies of adolescents

MOTHERS  1 EMPLOYED
WORKING
STATUS  2 HOUSEWIFE

 1 HINDU
 2 CATHOLICS
RELIGION  3 MUSLIM
ANY OTHER, SPECIFY
 4

 1 JOINT FAMILY
FAMILY TYPE
 2 NUCLEAR FAMILY

BIRTH ORDER  1 ONLY CHILD

 2 ELDER SIBLING
 3 MIDDLE SIBLING
 4 YOUNGEST SIBLING

 1 2 Lac and Above

 2 1,50,000 – 2,00,000
Annual Family
 3 1,00,000 – 1,50,000
Income
 4 50,000 – 1,00,000
 5 Below 50,000
 Mental Health in relation to Quality of Life and Coping Strategies of adolescents

Appendix II: Mental Health Battery

Arun Kumar Singh and Alpana Sen Gupta (2000)

Part 1

Instructions

Read the following questions carefully. In front of each question there are two options
‘Yes’ or ‘No’. You have to tick (√) in any one of them whichever you think is suitable
and correct. Do not leave any question. Your answers will be kept confidential.

S.N. STATEMENTS YES NO

1 When a person criticizes you, do you get angry?
2 If a teacher asks you some question in the class and you are not able to
answer, do you feel bad?
3 If you fail in an examination, do you feel like committing suicide?
4 Do you get afraid if your parents slightly rebuke or chide you?
5 Are you very afraid to see a snake, lizard, spider or any such reptiles?
6 Do you feel guilty if you go without completing your homework?
7 Do you silently sit after stealing anything belonging to your friend?
8 Do you feel good to criticize your friends?
9 Do you feel very happy for one moment and very sad in another?
10 If you lose in a game do you think your friend is to be blamed and
criticize him?
11 Do you feel very happy if your parents gave you a favourite thing?
12 Do you get upset if a close friend criticizes you?
13 Do you maintain your balance even in adverse situations?
14 Do you get angry if someone criticizes you even slightly?
15 Do you get more upset if a teacher scolds you on being indisciplined?

Part II

Instructions

Like Part I, each question have have two answers, Yes’ or ‘No’. out of these answers,
you have to select appropriate answer and tick the correct (√) mark either ‘Yes’ or
‘No’ i.e. any one in the box given below. Do not leave any question.

S.N. STATEMENTS YES NO

16 Is your relation with your parents comparatively better than other
members of your family?
17 If you do not go to school any day, do you feel uneasy at home?
18 Do you feel more self conscious while expressing your views before
others?
19 Are you always ready to take responsibilities in any social work?
20 Are you often unable to sleep at night?
 Mental Health in relation to Quality of Life and Coping Strategies of adolescents

21 Do you often indulge into hot discussions with your siblings due to one
reason or the other?
22 Do you like mixing with people very much?
23 Do you often complain of constipation?
24 Do useless topics often come into your thinking?
25 Do you feel suffocation in school or college environment?
26 Is your home environment peaceful?
27 Do you easily make friends with strangers?
28 Do you have complaints related to digestion?
29 Do you lose your balance if someone slightly criticizes you?
30 Do you like going to school or college everyday?
31 Don’t you do a work without taking permission of your parents?
32 Do you take help from others without any hesitation?
33 Do you wear glasses with power?
34 Do you get upset if someone insults you?
35 Do you like sharing a work along with your friends?
36 Do you feel that your family members like you lesser?
37 Do you want to be the key person in any social work?
38 Do you have less blood in your body?
39 Do you often feel helpless?
40 If your friend doesn’t have a book do you help him by offering your
own book?
41 Do you get worried, if your parents fall ill?
42 If you travel by train, do you easily make friends with your fellow
passengers?
43 In case of quarrel at home, do you try to pacify it?
44 Do you express your views before others without any hesitation?
45 Do you get nervous to see somebody bleeding?
YES NO
46 If you go to somebody’s house do you comment if you don’t get your
choice food?
47 Are you often ahead of other students in a class competition?
48 Do members of your family do not love you as they should?
49 Do you often keep silent even if you don’t like something?
50 Do you take care if your neighbours?
51 Do you like to stay at your friend’s house instead of staying at home?
52 If you go to any of your relatives, do you easily get adjusted in that
environment?
53 Do your parents criticize you, if you make a mistake?
54 Do you feel unusual nervousness when you see a spider or a lizard?
55 If a person wants to see various rooms of your house do you appreciate
him for this view?
 Mental Health in relation to Quality of Life and Coping Strategies of adolescents

Part III

Instructions

Given below are some situations which a person comes across in his day to day life.
Read these situations carefully and try to answer, if you were in that situation what
would you have done? Your answer should be any form of the two alternatives given
below for each question. So, whichever answer you think to be right, put a correct (√)
tick mark in the box in front of it. Do not leave any questions.

S.N. STATEMENTS WITH CHOICES MARK

You are going out with a friend in the evening. At that time you find a
money-purse lying on the road. There was some money and that
56 person’s address too. Your friend says, “Lets go with this money to a
hotel for a good meal and then go to a movie.” In such a situation what
would you do?
a. Agree with your friend?
b. Disagree with your friend’s view?

Your parents want you to get into a business so you can earn good
money. But you want to become a good doctor so that you can serve
57
people and treat poor and helpless. What would you do in such a
situation?
a. Agree with your father’s view?
b. Begin preparation for medical examination?

If there is a quarrel among your friends in class and it results in

58
fighting, what would you do in such a situation?
a. Try and pacify the quarrel.
b. Remain neutral and enjoy it.

Your examinations are at hand. Your parents ask you to give more time
59 to your studies but your attention often goes towards movies and games.
What would you do in such a situation?
a. You would not listen to your parent’s advice?
b. Not take interest in games and entertainment?

If while walking on road a person meets with an accident and you reach
60
there all of a sudden, what would you do in such a situation?
a. You would try to take that person to a doctor or hospital?
b. Watch the person for some time and then walk away?

If your brother or your sister brings an eraser or a pencil stolen from school,
you rebuke him and make him understand that stealing is a bad habit. If he
61 steals someone’s belongings, people call him a bad person. But one day your
friend steals Rs. 500 and comes with the money and says, “Let us enjoy with
this amount.” What would you do in such a situation?
a. You will make your friend understand not to do so?
b. Support your friend?
 Mental Health in relation to Quality of Life and Coping Strategies of adolescents

In an examination the questions are very tough and you know the
answers. Your friend asks you to tell him the answer. As a friend, you
think you should help him. But at the same time, it comes to your mind
62
that cheating in examinations or helping others both are offences in an
examination and if the examiner catches, he will also severely punish
you. What would you do in such a situation?
a. With courage try to make possible help to the friend.
b. Rebuke the friend.

At home, if your parents quarrel over some issue, you get worried for
63
sometime, what would you do in such a situation?
a. You will try to pacify your mother or father or both.
b. You won’t go near them because of fear.

64 If a new teacher comes to your class. Some students try to harass him.
What would you do in such a situation?
a. You won’t take your friends side.
b. You will tell your friends some new ways to harass the new teacher.

65 If some boys flee from your school to watch a movie, thus committing an act of
indiscipline. When you came to know about this, what would you do?
a. You would report to your teacher about those boys.
b. Will remain neutral and do your work.

66 If your friend’s father falls ill and he doesn’t even have money for his
treatment, what would you do
a. Will arrange money for the treatment of the friend’s father.
b. You will sympathize your friend

67 While traveling by bus if a person is caught fleeing with somebody’s

expensive belongings what would you do?
a. Will sit calmly and watch the drama?
b. Try your best to get the person punished?

68 If you come to know that your friend doesn’t have books to read, though he is
very interested to study, as his poor parents somehow manage their expenses
of house. In such a situation what would you do?
a. Will give your own books to read for some time?
b. You’ll promise to get him a book?

69 If a boy does caricature of the teacher in the class, to make his friends
laugh and you see the boy doing so, what you do?
a. You will indication to the boy not to do so?
b. You will complain to the teacher in the middle of the class?

70 While taking bath in a river or lake, you see small child drowning. In that
situation, what would you do?
a. You will loudly cry out ‘Help’, ‘Help’.
b. Try to save him yourself.
 Mental Health in relation to Quality of Life and Coping Strategies of adolescents

Part IV

Instructions

In this, there are some questions related to your behavior. There are no fixed answers
to these questions, so whichever answer you think right, will be the right answer for
you and you have to mark the answer below either ‘Yes’ or ‘No’ in the boxes provided
with a correct (√) mark. Do not leave any question.

Sr. STATEMENTS YES NO

No.
71 Are you afraid, if your parents are not at home?
72 Do you become disturbed, if while on road the lights suddenly go
off?
73 Does your anxiety / perplexity increases during a quarrel at home?
74 Do you feel more anxious if your family members come late to
receive you at railway station?
75 Do you feel afraid, thinking of going alone at night?
76 Do you feel lonely while in the midst of friends?
77 Do you depend on your friends?
78 Do you feel difficulty in expressing your own feelings?
79 Do you feel that you are well adjusted in your environment?
80 Do you feel that you are deprived of much happiness?
81 Do you feel nervousness while you are introduced to new people?
82 Do you get more praise from people?
83 Do you often remain depressed?
84 Do you feel unhappy due to negligible things?
85 Are you not afraid of any kind of competition?

Part V

Instructions

Read the following statements carefully. In front of each question there are two
answers given, that is ‘Right’ or ‘Wrong’. Out of which you have to select the most
appropriate and correct one and make a (√) sign on it. Do not leave any question.

Sr. STATEMENTS RIGHT WRONG

No.
86 I feel that my behavior is mature.
87 My stock of general knowledge is sufficient.
88 I can quickly solve the complicated problems.
89 My aspirations are real or realistic in nature.
90 I have to often face any type of obstacles in way of
progress.
 Mental Health in relation to Quality of Life and Coping Strategies of adolescents

91 I have full expectation that one day I will leave behind

all my competitors.
92 Some persons are very upset due to my success.
93 My expectations are based on my success.
94 I never faced any failure in my life.
95 Each person must try sincerely to be successful in life.
96 My success is always effective.
97 Till now I have not met a person who criticizes my
achievements.
98 My personal habits proved to hinder my achievements.
99 I often feel that a little gain is achieved after several
attempts.
100 My achievements are definitely criticized on certain
grounds.
 Mental Health in relation to Quality of Life and Coping Strategies of adolescents

Appendix III: World Health Organization’s Quality Of Life Scale - BREF

(WHOQOL)-BREF

By World Health Organization (WHO)

Very Poor Neither Good Very

Poor Poor nor Good
Good
1 How would you rate 1 2 3 4 5
your quality of life?

Very Dissatisfied Neither Satisfied Very

Dissatisfied Satisfied nor Satisfied
Dissatisfied
2 How satisfied are you 1 2 3 4 5
with your health?

The following questions ask you how much you have experienced certain
things in the last weeks.
Not at all A little A Very An
moderate much extreme
amount amount
To what extent do you 1 2 3 4 5
3 feel that physical pain
prevents you from
doing what you need to
do?
How much do you need 1 2 3 4 5
any medical treatment
4 to function in your
daily life?

How much do you 1 2 3 4 5

5 enjoy life?

To what extent do you 1 2 3 4 5

6 feel your life to be
meaningful?
 Mental Health in relation to Quality of Life and Coping Strategies of adolescents

Not at all A little A moderate Very Extremely

amount much
How well are you able 1 2 3 4 5
7 to concentrate?
How safe do you feel 1 2 3 4 5
8 in your daily life?
How healthy is your 1 2 3 4 5
9 physical environment.

The following questions ask about how completely you experience or were
able to do certain things in the last two weeks.
Not at all A little Moderate Mostly Completely
Do you have enough 1 2 3 4 5
10 energy for everyday
life?
Are you able to accept 1 2 3 4 5
11 your bodily
appearance?

Have you enough 1 2 3 4 5

12 money to meet your
needs?

How available to you 1 2 3 4 5

13 is the information that
you need in your day-
to–day life?
To what extent do you 1 2 3 4 5
14 have the opportunity
for leisure activities?

Very Poor Neither Good Very

Poor Poor nor Good
Good
How well are you able 1 2 3 4 5
15 to get around

The following questions ask you to say how good or satisfied you felt about
various aspects of your life over the last two weeks

Very Dissatisfied Neither Satisfied Very

Dissatisfied Satisfied Satisfied
nor
Dissatisfied
How satisfied are 1 2 3 4 5
16 you with your sleep?
 Mental Health in relation to Quality of Life and Coping Strategies of adolescents

How satisfied are 1 2 3 4 5

17 you with your ability
to perform your
daily living
activities?
How satisfied are 1 2 3 4 5
18 you with your
capacity to work?
How satisfied are 1 2 3 4 5
19 you with yourself
How satisfied are 1 2 3 4 5
20 you with your
personal
relationships?
2 How satisfied are 1 2 3 4 5
1 you with your sex
life?
2 How satisfied are 1 2 3 4 5
2 you with the support
you get from your
friends?
2 How satisfied are 1 2 3 4 5
3 you with the
conditions of your
living place?
2 How satisfied are 1 2 3 4 5
4 you with access to
health services?
25 How satisfied are 1 2 3 4 5
you with your
transport?

The following question refers to how often you have felt or experienced
certain things in the last two weeks

Never Seldom Quite often Very Always

often
How often do you have 1 2 3 4 5
26 negative feelings such
as blue mood, despair,
anxiety, depression?
 Mental Health in relation to Quality of Life and Coping Strategies of adolescents

Did someone help to fill out this form?

___________________________________

How long did it take to fill this form out?

__________________________________

Do you have any comments about the assessment?

_______________________________________________________________

THANK YOU FOR YOUR HELP

 Mental Health in relation to Quality of Life and Coping Strategies of adolescents

Appendix IV: Adolescent Coping Scale

Erica Frydenberg & Ramon Lewis (1993)

General Scale

Instructions:

Students have a number of concerns or worries about things such as school, work,
family, friends, the world and the like. Below is a list of ways in which people of your
age cope with a variety of concerns and problems. Please indicate by marking the
appropriate box, the things you do to deal with your concerns and worries. Work
down the page and mark 1, 2, 3, 4, or 5 as you come to each statement. There are no
right and wrong answers. Do not spend too much time on any statement but give the
answer which describes how you feel.

1 2 3 4 5
Doesn’t apply or Used very little Used sometimes Used Often Used a great
don’t do it deal

Sr. 1 2 3 4 5
No
1. Talk to others to see what they would do if they
had the problem
2. Work at solving what’s causing the problem
3. Keep up with work as required
4. Play sport
5. Let God take care of my worries
6. Ask for advice from a qualified person
7. Worry about my future
8. Make a good impression on others who matter to
me
9. There is nothing I can do about the problem so I
don’t do anything
10. I just give up
11. Meet with friends
12. Cry or scream
13. Hope for the best
14. Ring up a close friend
15. Keep my feelings to myself
16. Ignore the problem
17. Talk to others and give each other support
18. Work at solving the problem to the best of my
ability
19. Attend school regularly
 Mental Health in relation to Quality of Life and Coping Strategies of adolescents

20. Keep fit an healthy

21. Remember those who are worse off so my
troubles don’t seem so bad
22. Pray for help and guidance so that everything
will be alright
23. Get professional help or counseling
24. Worry about my happiness
25. Work hard
26. Find a way to relax; for example listen to music,
read a book, play a musical instrument, watch
television
27. Make myself feel better by taking alcohol,
cigarettes or other drugs (Not medication)
28. I get sick
29. Wish a miracle would happen
30. Avoid being with people
31. Seek encouragement from others
32. Consider other points of view and try to take
them into account
33. Worry about my relationship with others
34. Go for a workout at the gym
35. Look on the bright side of things and think of all
that is good
36. Read a holy book
37. Worry about what is happening
38. Try to ‘fit in’ with my friends
39. Organize an action petition regarding my concern
40. Get into a steady relationship
41. Hope that the problem will sort out itself
42. Criticize myself
43. Keep others from knowing what’s worrying me
44. Think about what I am doing and why
45. Achieve well in what I am doing
46. Go out and have a good time and forget about my
troubles
47. Try to have a cheerful outlook on life
48. Pray to God to look after me
49. Organize a group to deal with the concern
50. Improve my relationship with others
51. Realize that I make things difficult for myself
52. Go to meetings which look at the problem
53. Try to make close friends with a guy or girl
54. Daydream about how things will turn out well
55. I have no way of dealing with the situation
56. Blame myself
57. Don’t let others know how I am feeling
58. Consciously ‘block out’ the problem
59. Talk to other people about my concern to help
me sort it out
 Mental Health in relation to Quality of Life and Coping Strategies of adolescents

60. Work instead of going out

61. Ask a professional person for help
62. Be happy with the way things are
63. I suffer headaches or stomach aches
64. Worry about what will happen to me
65. Put the problem out of mind
66. Do as my friends want
67. Join with people who have the same concern
68. Take my frustrations out on others
69. Imagine that things will work out
70. See myself as being at fault
71. Get support from others such as parents or
friends
72. Discuss the problem with qualified people
73. Worry about the future of the world
74. Make time for leisure activities
75. Change the amount I eat, drink or sleep
76. Shut myself from the problem so that I can avoid
it
77. Spend more time with boy/girl friend
78. Think of different ways of dealing with the
problrm
79. Find a way to let off steam; for example cry,
scream, drink, take drugs
80. List any other things you do to cope with your
main concern
 Mental Health in relation to Quality of Life and Coping Strategies of adolescents

Appendix V: Adolescent Coping Scale

Erica Frydenberg & Ramon Lewis (1993)

Specific Scale

Instructions:

Students have a number of concerns or worries about things such as school, work,
family, friends, the world and the like. Which is the main concern for you in terms of
your life? Please describe your main concern, very briefly, in the space below
…………………………………………..

Below is a list of ways in which people of your age cope with a variety of concerns
and problems. Please indicate by marking the appropriate box, the things you do to
deal with your concerns and worries. Work down the page and mark 1, 2, 3, 4, 05 5 as
you come to each statement. There are no right and wrong answers. Do not spend too
much time on any statement but give the answer which describes how you feel.

1 2 3 4 5
Doesn’t apply or Used very little Used sometimes Used Often Used a great
don’t do it deal

Sr. 1 2 3 4 5
No
1. Talk to others to see what they would do if they
had the problem
2. Work at solving what’s causing the problem
3. Keep up with work as required
4. Play sport
5. Let God take care of my worries
6. Ask for advice from a qualified person
7. Worry about my future
8. Make a good impression on others who matter to
me
9. There is nothing I can do about the problem so I
don’t do anything
10. I just give up
11. Meet with friends
12. Cry or scream
13. Hope for the best
14. Ring up a close friend
15. Keep my feelings to myself
16. Ignore the problem
17. Talk to others and give each other support
 Mental Health in relation to Quality of Life and Coping Strategies of adolescents

18. Work at solving the problem to the best of my

ability
19. Attend school regularly
20. Keep fit an healthy
21. Remember those who are worse off so my
troubles don’t seem so bad
22. Pray for help and guidance so that everything
will be alright
23. Get professional help or counseling
24. Worry about my happiness
25. Work hard
26. Find a way to relax; for example listen to music,
read a book, play a musical instrument, watch
television
27. Make myself feel better by taking alcohol,
cigarettes or other drugs (Not medication)
28. I get sick
29. Wish a miracle would happen
30. Avoid being with people
31. Seek encouragement from others
32. Consider other points of view and try to take
them into account
33. Worry about my relationship with others
34. Go for a workout at the gym
35. Look on the bright side of things and think of all
that is good
36. Read a holy book
37. Worry about what is happening
38. Try to ‘fit in’ with my friends
39. Organize an action petition regarding my concern
40. Get into a steady relationship
41. Hope that the problem will sort out itself
42. Criticize myself
43. Keep others from knowing what’s worrying me
44. Think about what I am doing and why
45. Achieve well in what I am doing
46. Go out and have a good time and forget about my
troubles
47. Try to have a cheerful outlook on life
48. Pray to God to look after me
49. Organize a group to deal with the concern
50. Improve my relationship with others
51. Realize that I make things difficult for myself
52. Go to meetings which look at the problem
53. Try to make close friends with a guy or girl
54. Daydream about how things will turn out well
55. I have no way of dealing with the situation
56. Blame myself
57. Don’t let others know how I am feeling
 Mental Health in relation to Quality of Life and Coping Strategies of adolescents

58. Consciously ‘block out’ the problem

59. Talk to other people about my concern to help
me sort it out
60. Work instead of going out
61. Ask a professional person for help
62. Be happy with the way things are
63. I suffer headaches or stomach aches
64. Worry about what will happen to me
65. Put the problem out of mind
66. Do as my friends want
67. Join with people who have the same concern
68. Take my frustrations out on others
69. Imagine that things will work out
70. See myself as being at fault
71. Get support from others such as parents or
friends
72. Discuss the problem with qualified people
73. Worry about the future of the world
74. Make time for leisure activities
75. Change the amount I eat, drink or sleep
76. Shut myself from the problem so that I can avoid it
77. Spend more time with boy/girl friend
78. Think of different ways of dealing with the
problem
79. Find a way to let off steam; for example cry,
scream, drink, take drugs
80. List any other things you do to cope with your
main concern